A New Opening for Transparency and Transformation – The Benefits Of The Community Dataset

Today’s Presentation

• To update you on progress with the development of the Community Information Data Set (CIDS)

• To help you focus on your plans for the national implementation of the CIDS

• To highlight the benefits that CIDS will bring

• To give some examples of reporting capability of CIDS

• To give you the opportunity to ask questions

Community Information Data SetKey Driver for Development / Business Requirement

NHS currently spends more than £10bn every year on community services

BUT

Currently no way of accurately monitoring the quantity, the cost or the quality of these services; no national definitions or processes exist to collect and report common activity/ outcome data for local and/or national comparison

HOWEVER

Community services are strategically vital in enabling the shift of care from acute settings to deliver the government’s vision for world-class health outcomes and quality health services

Timeline for Implementation

• Phase 1 from April 2011Local collection and use to meet requirement to report AHP RTT and support transformation of local services

• Phase 2 from 7 months following approval of fundingCommence implementation of national collection and flow via Secondary User Services

• Outstanding Issues to be Addressed for Phase 2ISB Approval – ROCR / NIGB approval being soughtDecision on affordability

Even Without A Funding Decision

• Planning to publish Community Dataset for April 2011 prior to ISN

• Resource pack will be available on Information Centre Website to support implementation

Implementation Plan Template State of Readiness Assessment Tool FAQ’s Product Sheet

• Demand and market from new community service providers will increase as community services are opened up with choice and competition

• Early Demonstration sites (First of Type)

Even Without A Funding Decision

Implications For Community Service Organisations

• Part of Monitor Compliance Framework Q3 2011/12• QIPP – more of the same is not an option• NHS contract monitoring• Meeting of technical requirements of Operating Framework

2011/12• NHS Outcomes Framework • Improved Commissioning• Part of the Guidance Framework for Any Willing Provider• Strategic Priority for Official Statistics on Health and Social

Care

Data Set Model

Principles

• Patient level secondary uses dataset • Includes patients in contact with Community Services

(NHS Standard Community Contract) • Covers entire community patient pathway i.e. referral to

discharge • Developed in conjunction with Expert Reference Group• Aligns to existing NHS Data Dictionary and other national

standards wherever possible  • Based on information routinely captured for primary use or

local administration purposes

CIDS dataset

• Output Dataset Mandatory/Required/Optional          

• Unique Identifiers e.g. Service Referral/Care Contact etc

• Pilot Items

• It’s the start and not the finish of what needs to be collected, understood and acted upon

Dataset Content

• Person details/demographics

• Service Referral

• Referral to Treatment

• Care Contact Activities– Assessments– Activities– Outcomes

• Group Sessions

Reporting Potential

• Systems are key – ease of input and extract• Consistency – do once and share!• Identify relevant data – organisation and content• Value mapping – do not need to collect only national

values• Need to correctly associate data items in system and

extract

Numbers of Activity by Duration and Staff Group

0 2,000 4,000 6,000 8,000 10,000 12,000

District NurseCommunity Nurse

PhysiotherapistHealth Visitor

Community MatronStaff Nurse

PodiatristHealth Care Assistant

Occupational TherapistSpeech and Language Therapist

Chiropodist Specialist Nurse

OtherDietitian

Specialist Nurse - Community Respiratory Not known

Specialist Nurse - DiabetesRehabilitation Nurse

Specialist Nurse - StrokeClinical Psychologist

AudiologistTechnical Instructor

CounsellorPsychotherapist

School Nurse

Number of activities

0-15 16-30 31-45 46-60 61-90 90+

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Number of Activities by Duration and Activity Group

0 5,000 10,000 15,000 20,000 25,000 30,000

Clinical Interv ention

Assessment

Supporting w ith medication

Counselling, Adv ice, Support

Indirect Activ ity

Administering Tests

Patient Specific Health Promotion

General Health Promotion

Number of activities

0-15 16-30 31-45 46-60 61-90 90+

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Number of Activities by the Ageof Patient for Selected Staff Groups

0 2,000 4,000 6,000 8,000 10,000 12,000

District Nurse

Staff Nurse

Health Visitor

Community Nurse

Physiotherapist

Community Matron

Podiatrist

Speech and Language Therapist

Health Care Assistant

Number of activities

Under 18 18-35 36-64 65+

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Number of Initial Activities by Duration Recorded for District Nurses on Two Sites

0

5

10

15

20

25

0-15 16-30 31-45 46-60 61-90 90+

Activity duration in minutes

Nu

mb

er

of

acti

vit

ies

Site 1 Site 2

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Number of Follow up Visits byActivity Duration Recorded for District Nurses for 2 Sites

0

500

1,000

1,500

0-15 16-30 31-45 46-60 61-90 90+

Activity duration in minutes

Nu

mb

er o

f ac

tivi

ties

Site 1 Site 2

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Number of Referrals by Primary Reason where Source of Referral is a Hospital

0 50 100 150 200 250 300 350 400

Drug InterventionOrthopaedic

COPDNon Healing Surgical

AssessmentFall

Respiratory ConditionsDevelopmental

Mobility ProblemsCatheter Problems

NeurologicalFacilitate Early

CancerWound CareBladder Care

Cardiac ConditionsBow el Care

DiabetesAutism

Pain / SymptomParkinsons Disease

Mental HealthTuberculosis

Advice and SupportLeg Ulcer

DermatologyPressure Ulcer

Moving and HandlingHead Injury

End of life supportSleep Problems

RehabilitationContinence Problems

Palliative CareEating Disorder

Ophthalmic ProblemsPressure Area Care

Cleft PalateNew Birth

Accident / TraumaEpilepsy

Ante Natal

Number of referrals

Number of referrals

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Number of Cancelled Activitiesby Activity Group and Cancellation Reason

0 20 40 60 80 100 120 140 160 180 200

Clinical Intervention

Assessment

Indirect Activity

General Health Promotion

Number of cancellations

Cancelled due to Clinical ReasonsCancelled due to Non-clinical Reasons

Data Source: Community Dataset Proof of Concept data, 2010Extreme caution should be taken when interpreting the data. This is proof of concept data and is not representative of all community services and providers. This data should not be used for management and performance purposes.

Referral to Treatment Times Driving Service Improvement

• Bathing Assessment Team Northumberland Care Trust reduced RTT from 26 weeks to 1 week (96% improvement)

• Children’s Occupational Therapy Coventry Community Health Services reduced waits from a average of 9-17 months depending on clinical priority to 2 weeks for all referrals (94% - 96% improvement)

• Adolescent Chronic Fatigue Service, University College Hospital reduced waits from14 weeks to 4 weeks (71% improvement)

Conclusion

• There is potential to obtain and report accurate data which provides information that will drive, support and demonstrate the potential and actual quality and efficiency gains in community services.

• It will not be easy to undertake this development but it is essential to the future of these services

• Time and effort must be made to support clinicians to confidently and competently utilise clinical applications and deploy mobile solutions to enable data collection and completeness

Questions and Discussion